Although it takes a thorough assessment before a clinician –therapist or psychologist – can diagnose a teen with depression, there are some classic indications that point to depression in an individual. Depression can play out in different ways for different age groups. However, some teen depression symptoms that youth might experience include:

• Anger and aggression, especially in male depressed teens
• Low self-esteem, high self-criticism, extreme pessimism, especially if they are female
• Anxiety
• Confused and dysfunctional thinking
• High self-consciousness
• Irritable / depressed mood – the DSM allows for irritable mood to substitute for depressed mood in the criteria for making a diagnosis for depression.
• Loss of interest in activities
• Poor interpersonal problem solving and high stress from close relationships
• Antisocial behavior, particularly in males
• Sleep disturbance – insomnia / hypersomnia
• Appetite disturbance – weight loss/gain
• Difficulty coping with stress from relationships, family environment, or depressed parents
• Symptoms of other mental illnesses, which are common to co-exist with adolescent depression, such as ADHD, eating disorders, anxiety disorders, and substance use disorders.
• Guilt
• Suicidal thoughts
• Poor concentration
• Poor memory
• Indecision
• Slow thinking
• Headaches
• Constipation

The mental health field currently recognizes that the combination of the right medication along with therapy as the best form of treatment.

One common form of therapy utilized during treatment for teens with depression is Cognitive Behavioral Therapy (CBT). The reason why it’s so widely used, especially for adolescents, is because it aims to change behavior by identifying negative and distorted thinking patterns. This successful form of therapy emphasizes the link between thoughts, feelings, and behavior, and more importantly, it attempts to identify the way that certain thoughts contribute to the unique problems of an adolescent’s life. By changing the thought pattern, both feelings and behavior change, which can result in unraveling the many facets to depression.

There are four typical thought patterns that CBT aims to change, which in turn, might alleviate the symptoms of depression. These include:

Overgeneralization: This is the tendency to draw broad conclusions based on very limited data. For example, a teen might say to him or herself, “I’m worthless because I did poorly on my English exam,” even though she has excelled in all of her classes and will likely do well in English too.

Selective Abstraction: This is a thinking pattern in which an adolescent attaches a negative bias to one piece of information and excluding other pieces of information that indicate the opposite. For instance, a young teen might think that he is a horrible son because his parents are rarely home this week. He is not taking into account that his parents aren’t home because of extra responsibilities at work. He is excluding other pieces of information while focusing on one detail, which he is assigning a negative conclusion.

Arbitrary Inference: This is another form of reaching a conclusion without sufficient evidence. A depressed adolescent might think to herself that she is pathetic, that none of her teachers like her, and she is performing poorly in her classes, even though there is no evidence for this. Her teachers appreciate her and she is in fact doing well in school.

Magnification/Minimization: This is the tendency to exaggerate the negative and minimize the positive. For instance, a depressed teen might think to himself that he is a burden to others because of his health problems and that his presence isn’t worth anything. Although he might have an occasional health concern, he is magnifying it while also minimizing time spent volunteering in the community.

CBT is an effective form of therapy for treating teen depression. However, it’s important to focus on not only the transformation of thinking, but behavior as well. To do this, CBT not only provides teens with healthier thoughts but also with healthy coping mechanisms, social skills, problem-solving skills, and communication skills.

Along with therapy, it is the relationship with the therapist that a teen has that makes therapy a strong source of support when circumstances at home or school get rough. Furthermore, the strength of this relationship along with the proper use of psychotropic medication can make all the difference in healing from teen depression.

Reference:

Richards, S. & Perri, M.G. (2002). Depression: A primer for practitioners. Thousand Oaks, CA: Sage Publications.